Jobs
>
Reno

    Utilization Review Specialist - Reno, Nevada, United States - Reno Behavioral Healthcare Hospital

    Reno Behavioral Healthcare Hospital
    Reno Behavioral Healthcare Hospital Reno, Nevada, United States

    1 week ago

    Default job background
    Permanent
    Description

    The UR Specialist reviews and monitors patients' utilization of health care services with the goal of maintaining high quality, cost-effective care.

    The duties include providing the medical and utilization expertise necessary to evaluate the appropriateness and efficiency of medical services and procedures.

    Performs concurrent and retrospective reviews on all patients. Monitors level and quality of care.

    Responsible for the proactive management of patients with the objective of improving quality outcomes and decreasing costs.


    Evaluates and provides feedback to treating physicians regarding a patient's discharge plans and available covered services, including identifying alternative levels of care that may be covered.

    Monitors all utilization reports to assure compliance with reporting and turnaround times.

    Addresses care issues with the Director of Clinical Services and Chief Medical Officer/Medical Director as appropriate.

    Coordinates an interdisciplinary approach to support continuity of care.

    Provides utilization management, transfer coordination, discharge planning, and issuance of all appropriate authorization for covered services as needed.

    Identifies and recommends opportunities for cost savings and improving the quality of care across the continuum.

    Clarifies health plan medical benefits, policies and procedures for members, physicians, staff, contract providers, and outside agencies.

    Requirements

    Requirements

    Bachelor's degree in Social Work or related field required.

    Clinical Licensure in the State of Nevada preferred, no required

    Knowledge of medical terminology, medical records, and appropriate medical coding system.

    Working knowledge with software and/or equipment (Microsoft Office applications including Outlook, Word, Excel and PowerPoint).

    Maintains confidentiality of patients at all times.

    Benefits

    We proudly offer the following benefits available first of the month following just one month of employment:

    Competitive rates

    Flexible schedules

    Tuition reimbursement

    Comprehensive package of benefits to include: Medical

    Dental

    Vision

    Life, Pet, Identity Theft Insurance

    401k

    Generous paid time off

    Short Term and Long Term Disability
  • Reno Behavioral Healthcare Hospital

    Utilization Review Specialist

    2 weeks ago

    Reno Behavioral Healthcare Hospital Reno, United States

    Job Description · Job DescriptionThe UR Specialist reviews and monitors patients' utilization of health care services with the goal of maintaining high quality, cost-effective care. The duties include providing the medical and utilization expertise necessary to evaluate the appro ...

  • Renobehavioral

    Utilization Review Specialist

    3 weeks ago

    Renobehavioral Reno, United States

    The UR Specialist reviews and monitors patients' utilization of health care services with the goal of maintaining high quality, cost-effective care. The duties include providing the medical and utilization expertise necessary to evaluate the appropriateness and efficiency of medi ...

  • Reno Behavioral Healthcare Hospital

    Utilization Review Specialist

    4 weeks ago

    Reno Behavioral Healthcare Hospital Reno, United States

    The UR Specialist reviews and monitors patients' utilization of health care services with the goal of maintaining high quality, cost-effective care. The duties include providing the medical and utilization expertise necessary to evaluate the appropriateness and efficiency of medi ...

  • Clerical Administrative Support

    Referral Specialist

    1 week ago

    Clerical Administrative Support Reno, United States Full time

    Position Purpose · This position's primary function is to process authorization requests timely and accurately in accordance with federal, state and accreditation guidelines. This position will be responsible for the completion of authorizations, including but not limited to, da ...

  • Westinghouse Electric Company, LLC

    Senior Nuclear Planner

    3 weeks ago

    Westinghouse Electric Company, LLC Sierra, United States

    Westinghouse is seeking a Senior Nuclear Planner for a 12+ month contract assignment supporting our nuclear client in Surry, VA. · This position will provide technical support by reviewing Design Changes (DC) packages prior to implementation. This DC preparation will include rev ...

  • IncAuthority

    Marketing Specialist

    1 week ago

    IncAuthority Reno, United States

    Inc Authority is looking for a full-time Reno Based "Marketing Specialist" · Explore the Inc Authority Advantage · Why Join Us? · Industry Leadership: Inc Authority is the gateway to small business success in all 50 states We're not just leading the pack; we're setting the sta ...

  • Allied Health

    Clinical Pharmacist_Outpatient

    2 weeks ago

    Allied Health Reno, United States Per Diem

    Position Purpose · The Clinical Pharmacist_Outpatient provides evidence based pharmaceutical care services to include: · • Pharmacotherapy consults · • Disease management support · • Medication reconciliation · • Assessment of polypharmacy issues · • Recommendations to support ...

  • State of Kansas

    Sr Admin Asst

    3 weeks ago

    State of Kansas Reno, United States

    Employment Benefits · Comprehensive medical, mental, dental, vision, and additional coverage · Sick & Vacation leave · Work-Life Balance programs: parental leave, military leave, jury leave, funeral leave · Paid State Holidays (designated by the Governor annually) · Fitn ...

  • University of Nevada, Reno

    Specialist, Women's Basketball Player Development

    2 weeks ago

    University of Nevada, Reno Reno, United States Full time

    Job Description · The University of Nevada, Athletics is recruiting for a Specialist, Women's Basketball Player Development. The Specialist, Women's Basketball Player Development will collaborate with the coaching staff, Director, Women's Basketball Player Development and Manage ...

  • Renown Health

    Film Room Digital Imaging Specialist

    3 hours ago

    Renown Health Reno, United States

    Position Purpose · This position is accountable for full responsibility of daily image records maintenance for all of Renown Health System. Other responsibilities include: Connecting MDs/RNs/Technologists with Radiologists regarding imaging studies, Upload imaging studies to/from ...

  • Bass Pro Shops

    Human Resource Specialist

    6 days ago

    Bass Pro Shops Reno, United States Full time

    POSITION SUMMARY: · The Human Resources Specialist will lead onsite HR initiatives supporting leadership and Outfitters in the store in the following areas: staffing, training, engagement, orientation and onboarding, and administrative excellence. Additionally, this role will as ...

  • Truckee Meadows Community College

    Cyber Security Specialist

    2 weeks ago

    Truckee Meadows Community College Reno, United States Full time

    Description · We are seeking a motivated and passionate individual to join our team as a Senior Cybersecurity Specialist. This role presents an excellent opportunity for the right candidate. Whether you're relatively new to the field, but with a foundational grasp of cybersecuri ...

  • BHI Energy

    Quality Assurance Technician

    1 week ago

    BHI Energy Reno, United States Full time

    Details: · Job Summary: The Quality Control Technician is responsible for the verification of purchased product, incoming inspection of purchased materials, and finished goods acceptance. Quality system requirements are effective in accordance with 21 CFR 820, ISO 13485 for Medi ...

  • Renown Health

    Referral Specialist

    1 week ago

    Renown Health Reno, United States

    Position Purpose This position#s primary function is to process authorization requests timely and accurately in accordance with federal, state and accreditation guidelines. This position will be responsible for the completion of authorizations, including but not limited to, data ...

  • GGRM Law Firm

    Associate Attorney

    2 weeks ago

    GGRM Law Firm Reno, United States

    Workers' Compensation Associate Attorney · Want to make a difference in the lives of those who have been injured? Enjoy interacting with clients? Come join our team at GGRM Law Firm and help us represent our clients with excellence and compassion. We have proudly served Nevada fo ...

  • Westinghouse Electric Company, LLC

    Senior Nuclear Planner

    1 day ago

    Westinghouse Electric Company, LLC Reno, United States

    Westinghouse is seeking a Senior Nuclear Planner for a 12+ month contract assignment supporting our nuclear client in Surry, VA. This position will provide technical support by reviewing Design Changes (DC) packages prior to implementation. This DC preparation will include review ...

  • GGRM Law Firm

    Associate Attorney

    1 week ago

    GGRM Law Firm Reno, United States

    Workers' Compensation Associate Attorney · Want to make a difference in the lives of those who have been injured? Enjoy interacting with clients? Come join our team at GGRM Law Firm and help us represent our clients with excellence and compassion. We have proudly served Nevada fo ...

  • EMPLOYERS

    Agency Management Specialist I

    1 day ago

    EMPLOYERS Reno, United States

    Job Description · Location: Reno, NV · Job_Code: 6128 · # of Openings: 1 · Agency Management Specialist I | Position is 100% remote, preference given candidates that reside in Reno, NV. · General Summary: · Under the direction of the Supervisor, Agency Management, this position i ...

  • City of Reno

    Court Specialist

    3 weeks ago

    City of Reno Reno, United States

    Court Specialist · Print Subscribe · Class Title · Court Specialist · Class Code · 1522 · Salary · $45, $60,985.60 Annually · + Definition · + Benefits · Classification Description Summary · Under supervision, performs a wide variety of specialized clerical, technical, ...

  • Nichols Consulting Engineers, Chtd. (NCE)

    Senior Civil Engineer

    2 days ago

    Nichols Consulting Engineers, Chtd. (NCE) Reno, United States

    Senior Civil Engineer · NCE is looking for energetic and motivated Senior Civil Engineers to join the talented and diverse infrastructure group in Northern Nevada. We get the satisfaction of improving our communities, designing safer and more reliable roadways, improving multi-m ...